3 Txoj Kev Kho DVT

Cov txheej txheem:

3 Txoj Kev Kho DVT
3 Txoj Kev Kho DVT

Video: 3 Txoj Kev Kho DVT

Video: 3 Txoj Kev Kho DVT
Video: Txoj Kev Av By XAI THAO [ Cover ] 2024, Lub peb hlis ntuj
Anonim

Txoj hlab ntshav sib sib zog nqus ntshav (DVT) feem ntau kho nrog cov tshuaj ua kom ntshav qis hu ua anticoagulants. Qhov kev kho mob feem ntau yog chav kawm ntawm anticoagulants, txawm tias heparins, LMWHs, lossis warfarin. Anticoagulants txhais tau tias tiv thaiv kev loj hlob ntxiv ntawm cov khov los yog tsim cov tshiab thaum koj lub cev ua haujlwm kom "yaj" cov ntshav khov sai dua. Koj yuav zoo li yuav tsum tau noj tshuaj tsawg kawg peb lub hlis, thiab qee tus neeg yuav tsum tau noj lawv lub neej, nyob ntawm lawv qhov kev pheej hmoo thiab lwm yam xwm txheej kev noj qab haus huv. Txawm li cas los xij, hauv qhov xwm txheej hnyav, lossis xwm txheej uas tsis tuaj yeem siv tshuaj tiv thaiv kab mob antigagulants, koj tus kws kho mob yuav kho koj li DVT nrog cov lim ntshav tso rau hauv koj lub plab. Kev thom khwm thom khwm kuj tseem muaj txiaj ntsig rau txo qis o ntawm ob txhais ceg, thiab kev hloov pauv hauv lub neej zoo li tau txais kev tawm dag zog ntau tuaj yeem pab koj tswj hwm koj li DVT.

Cov kauj ruam

Txoj Kev 1 ntawm 3: Tshawb nrhiav DVT

Kho DVT Kauj Ruam 9
Kho DVT Kauj Ruam 9

Kauj Ruam 1. Saib xyuas cov tsos mob ntawm lub cev

DVT feem ntau yog nrog mob thiab/lossis o ntawm ib lossis ob txhais ceg. Qhov mob feem ntau pib ntawm lub plab hlaub. Koj txhais ceg yuav hnov mob lossis mob. Ntxiv nrog rau cov tsos mob cuam tshuam ncaj qha rau DVT, koj yuav tsum tau saib xyuas cov tsos mob ntawm tus kab mob hauv lub ntsws, qhov mob hnyav uas tshwm sim los ntawm DVT. Cov tsos mob no suav nrog:

  • Hnoos ntshav.
  • Hnov taub hau los yog lub taub hau me ntsis.
  • Mob hauv siab.
  • Ua tsis taus pa.
  • Lub plawv dhia sib tw.

Kauj Ruam 2. Xav txog koj qhov kev pheej hmoo

Ib tus neeg tuaj yeem tau txais DVT, tab sis qee tus neeg muaj kev pheej hmoo siab dua lwm tus. Cov tib neeg muaj kev pheej hmoo siab dua ntawm DVT suav nrog cov uas yog:

  • Tsev kho mob lossis cov uas nyuam qhuav tau phais.
  • Immobile.
  • Laus.
  • Rog dhau los lossis rog.
  • Muaj tsev neeg keeb kwm ntawm cov ntshav txhaws.
  • Tau muaj mob qog noj ntshav tsis ntev los no lossis rov tshwm sim.
  • Puas yog cev xeeb tub lossis nyuam qhuav muaj menyuam.
  • Noj tshuaj tiv thaiv hormonal los yog hloov tshuaj hloov tshuaj.
  • Tsis ntev los no tau raug mob.
Kho DVT Kauj Ruam 10
Kho DVT Kauj Ruam 10

Kauj Ruam 3. Tau txais ultrasound

Ib qho ultrasound (lossis ultrasonography) yog txheej txheem kev siv lub suab tsis zoo los tshuaj xyuas seb cov ntshav ntws los ntawm koj cov leeg. Ultrasound yog qhov kev ntsuam xyuas feem ntau siv los kuaj xyuas DVT. Qhov kev sim tsis cuam tshuam no tuaj yeem muab koj tus kws kho mob nrog cov duab ntawm lub sijhawm ntawm kev ua haujlwm sab hauv ntawm koj cov leeg thiab cov kabmob, uas tuaj yeem pab txiav txim siab qhov mob hnyav ntawm koj DVT thiab muab txoj hauv kev kho mob.

  • Koj tus kws kho mob yuav hais qhia cov txheej txheem cuam tshuam, ua ob lub ntsej muag ultrasound (lossis duplex ultrasound). Duplex ultrasonography zoo ib yam li ultrasound ib txwm muaj, tab sis nws saib xyuas cov ntshav thiab lwm yam khoom sab hauv thiab kua. Ob lub tshuab ultrasound tuaj yeem muab cov ntaub ntawv raug ntau ntxiv txog qhov nrawm thiab ntws ntawm cov ntshav.
  • Koj tus kws kho mob yuav pab koj teem sijhawm teem sijhawm nrog tus kws sau duab hauv chav kuaj ntshav yog tias lawv ntseeg tias koj yuav tsum tau kuaj qhov no, feem ntau ntawm tsev kho mob loj nrog cov cuab yeej siv sonography tsim nyog.
  • Thaum lub sijhawm sim, tus kws tshaj lij yuav siv cov txheej tuab ntawm cov gel rau koj ob txhais ceg thiab/lossis txhais taw, tom qab ntawd yoj lub tshuab hluav taws xob ultrasound hla lawv. Koj kuj tseem yuav tau hnav lub ntsuas ntshav siab.
Kho DVT Kauj Ruam 11
Kho DVT Kauj Ruam 11

Kauj Ruam 4. Sim kuaj ntshav D-dimer

Kev ntsuas D-dimer tshuaj xyuas cov ntshav rau cov ntshav me me uas tej zaum yuav tawg. Yog tias koj tus kws kho mob pom muaj coob tus ntawm cov pob txha tawg, muaj qhov yuav zoo dua uas koj muaj DVT.

Kho DVT Kauj Ruam 12
Kho DVT Kauj Ruam 12

Kauj Ruam 5. Muaj qhov sib piv venography xeem

Kev sib piv cov duab sib txawv cuam tshuam nrog kev pleev xim rau hauv cov leeg loj hauv ko taw lossis pob taws, tom qab ntawd siv X-ray lossis xoo hluav taws xob ntau lub sijhawm. Xoo hluav taws xob yuav qhia pom li cas koj cov leeg ntshav tau xa cov ntshav thoob plaws lub cev. Yog tias muaj cov ntshav txhaws lossis thaiv cov hlab ntshav, lawv yuav tshwm rau ntawm X-rays raws li thaj chaw uas cov xim zas xim.

Txoj Kev 2 ntawm 3: Kho DVT Nrog Tshuaj

Kho DVT Kauj Ruam 1
Kho DVT Kauj Ruam 1

Kauj Ruam 1. Sim heparin

Heparin yog anticoagulant. Ntawd yog, nws yog cov tshuaj uas thins cov ntshav txhawm rau kom xoob thiab txo cov ntshav khov. Kom tau txais heparin, mus ntsib koj tus kws kho mob. Lawv yuav txhaj tshuaj heparin ncaj qha nrog txhaj tshuaj, lossis txuas IV rau koj cov leeg ntshav kom raug.

  • Tom qab tau txais heparin, koj yuav tsum tau saib xyuas zoo. Koj tus kws kho mob yuav kuaj ntshav (lub sijhawm ua haujlwm thromboplastin ib nrab, lossis kuaj PTT) txhua hnub kom ntseeg tau tias koj tau txais tus nqi heparin raug txheeb ze rau qhov tshwm sim ntawm koj cov kev kuaj ntshav.
  • Heparin nws tus kheej tsis kim thiab ua tau nrawm, tab sis koj yuav tsum tau nyob hauv tsev kho mob rau qhov twg los ntawm peb txog 10 hnub nrog qhov kev xaiv no nyob ntawm koj qhov xwm txheej, uas tuaj yeem ua rau nws kim heev. Heparin kuj tseem yog qhov kev kho mob thawj zaug vim nws yooj yim pib thiab nres yog tias muaj teeb meem.
Kho DVT Kauj Ruam 2
Kho DVT Kauj Ruam 2

Kauj Ruam 2. Noj qis molecular hnyav heparins (LMWHs)

LMWHs zoo ib yam li heparins li niaj zaus hauv txhua qhov tshwj tsis yog ob qho. Ua ntej, tsis zoo li qub heparins, LMWHs tau pom zoo rau siv hauv tsev. Thiab qhov thib ob, koj yuav tsis tas yuav tau saib xyuas zoo li thaum siv LMWHs. Qhov no txhais tau tias kev siv LMWHs tuaj yeem txuag koj lub tsev kho mob ntev.

  • LMWHs kim kim dua li heparins li niaj zaus, tab sis raug nqi ntau dua nyob rau lub sijhawm ntev vim tias koj yuav tsis tau siv sijhawm nyob hauv tsev kho mob lossis them rau cov nqi kho mob ntsig txog.
  • Feem ntau LMWHs suav nrog dalteparin, enoxaparin, thiab tinzaparin. Qhov ntau npaum li cas rau cov tshuaj no sib txawv los ntawm qhov hnyav thiab yog tias nws yog rau kev kho lossis tiv thaiv ntshav khov. Cov no feem ntau siv ua ntej thiab tam sim tom qab kev phais txhawm rau tiv thaiv txhaws, xws li rau kev phais orthopedic.
Kho DVT Kauj Ruam 3
Kho DVT Kauj Ruam 3

Kauj Ruam 3. Tau txais warfarin

Warfarin, zoo li heparins, yog anticoagulant muab los ntawm koj tus kws kho mob. Tsis zoo li heparins, txawm li cas los xij, warfarin yog ntsiav tshuaj, tsis yog txhaj tshuaj. Nws kuj tseem ua qeeb dua li heparins, thiab feem ntau yuav tsis ncaws rau tsib rau xya hnub. Ib yam li nrog heparins, koj yuav tsum tau kuaj koj cov ntshav tas li (ob lossis peb zaug hauv ib lub lis piam) kom koj cov kws kho mob tuaj yeem txiav txim siab yog tias warfarin ua haujlwm thiab yog tias koob tshuaj yuav tsum raug kho.

  • Nyob ntawm koj tus mob, koj yuav tsum tau siv tshuaj warfarin li ob peb hnub, lossis tas koj lub neej.
  • Tsis txhob haus cawv thaum noj cov tshuaj warfarin. Cawv tuaj yeem ua rau cov ntshav ntau dhau thiab ua rau koj muaj qhov sib txawv ntawm cov ntshav ntau ntxiv thaum raug mob.
  • Ib qho ntawm cov teeb meem loj tshaj plaws rau tib neeg noj heparin yog qhov hloov pauv hauv kev noj zaub mov, tshuaj ntxiv, lossis tshuaj tuaj yeem hloov pauv cov tshuaj kom muaj txiaj ntsig thiab tuaj yeem ua rau xav tau kho qhov ntau npaum li cas. Yog li ntawd, qhov zoo tshaj plaws uas yuav tsum tau ua yog tswj hwm kev noj zaub mov zoo thiab ua kom ntseeg tau tias txhua tus kws kho mob uas sau tshuaj rau koj paub tias koj noj tshuaj heparin.

Kauj Ruam 4. Nug koj tus kws kho mob txog lwm yam tshuaj

Muaj lwm cov tshuaj muaj uas koj tuaj yeem tham nrog koj tus kws kho mob. Cov tshuaj anticoagulants tshiab tshaj plaws suav nrog rivaroxaban, apixaban, thiab dabigatran etexilate. Cov tshuaj no tsis muaj kev saib xyuas tib yam li warfarin, lossis ntau yam khoom noj/tshuaj sib cuam tshuam. Txawm li cas los xij, yog tias koj muaj teeb meem los ntshav, tsis yog txhua yam tshuaj muaj nyob muaj tus neeg thim rov qab.

Kho DVT Kauj Ruam 4
Kho DVT Kauj Ruam 4

Kauj Ruam 5. Sim ua clotbuster

Clotbusters siv rau qhov mob hnyav dua ntawm DVT. Hom clotbusters feem ntau yog thrombolytics (tseem hu ua cov nqaij plasminogen activators, lossis TPAs). Thaum cov tshuaj anticoagulants tuaj yeem tiv thaiv cov ntshav txhaws yav tom ntej, lawv tsis tau ua txhaum cov pob txha uas twb muaj los ntawm DVT. TPAs, ntawm qhov tod tes, tuaj yeem tsoo cov pob txha uas twb muaj lawm. Txawm li cas los xij, clotbusters tuaj yeem ua rau phom sij vim tias lawv yuav ua rau muaj ntshav loj. Cov tshuaj raug xa tawm los ntawm cov kws kho mob.

Kho DVT Kauj Ruam 5
Kho DVT Kauj Ruam 5

Kauj Ruam 6. Saib xyuas rau ib qho kev mob tshwm sim

Txhua txoj kev kho mob nws muaj nws cov kev mob tshwm sim. Cov kev mob tshwm sim ntawm heparin suav nrog mob taub hau, ua pob, ua rau pom zoo li mob khaub thuas, thiab mob plab. Kev txhaws pob txha tuaj yeem tshwm sim, tshwj xeeb yog poj niam cev xeeb tub. LMWHs muaj cov kev mob tshwm sim zoo ib yam, txawm hais tias muaj feem yuav ua rau pob txha puas qis dua. Cov kev mob tshwm sim ntawm warfarins suav nrog ua pob, mob taub hau, plaub hau poob, los ntshav, thiab nce siab rau cov enzymes.

  • Loj dua - tab sis tsis tshua muaj tshwm sim los ntawm warfarins suav nrog cov tawv nqaij necrosis (cov tawv nqaij tuag), cov ntiv taw liab liab (qhov xwm txheej uas koj cov ntiv taw yuav tig xiav lossis ntshav vim qhov ntshav tsis txaus), thiab los ntshav ntau. Yog tias koj muaj teeb meem staunching cov ntshav los ntawm kev txiav thiab khawb, lossis muaj ntshav hnyav hnyav, koj yuav tsum qhia rau koj tus kws kho mob.
  • Tam sim qhia cov no lossis lwm yam kev noj qab haus huv txawv txav mus rau koj tus kws kho mob tam sim ntawd.
  • Koj tus kws kho mob yuav txo koj daim ntawv xaj tshuaj lossis sau lwm txoj hauv kev kho yog tias koj ua tsis zoo rau qhov kev kho mob.

Txoj Kev 3 ntawm 3: Xav Txog Lwm Yam Tshuaj

Kho DVT Kauj Ruam 6
Kho DVT Kauj Ruam 6

Kauj Ruam 1. Muaj lub lim lim teeb tsa

Cov lim dej yog ib qho kev kho mob tsim nyog rau DVT thaum koj tsis tuaj yeem siv cov tshuaj thim ntshav. Lub lim nws tus kheej yog lub tshuab ntxaij mos mos uas tso cai rau cov ntshav nkag mus tab sis cuab cov ntshav txhaws. Lub lim dej tau nkag mus rau hauv cov hlab ntshav loj (vena cava) thiab tiv thaiv cov hlab ntshav uas yuav tawg los ntawm kev ua lawv txoj hauv kev rau koj lub ntsws.

  • Kev teeb tsa lim suab nrov tab sis qhov tshwm sim tiag tiag thaum koj tsaug zog. Koj tus kws kho mob yuav siv tus lej ua rau tus neeg mob lub plab, tom qab ntawd txiav mus rau hauv vena cava, siv lub tshuab ntsuas hluav taws xob txhawm rau coj tus raj mus rau qhov chaw raug. Thaum kawg, lub lim dej yuav snaked los ntawm txoj hlab pas thiab nthuav dav kom lim cov hlab ntshav.
  • Tsis tas yuav tsum tau lim lub tshuab lim lossis koom nrog. Sij hawm dhau mus, koj lub cev tus kheej cov tshuaj tiv thaiv kab mob yuav ua rau tawg ua rau cov ntshav txhaws.
  • Qee qhov lim dej tshem tau, tab sis feem ntau yog tas mus li. Txawm tias cov ntxaij lim dej tshem tawm feem ntau khaws cia rau hauv cov hlab ntshav yog tias koj muaj feem yuav tsim DVT dua tseem nyob siab. Koj tus kws kho mob yuav pab koj txiav txim siab seb koj puas xav tau lub lim dej huv lossis tshem tawm tau.
Kho DVT Kauj Ruam 7
Kho DVT Kauj Ruam 7

Kauj Ruam 2. Siv cov khoom ntim khov

Cov thom khwm thom khwm yog cov ris tsho tshwj xeeb uas ua kom ob txhais ceg thiab taw tsis txhob o. Kev thom khwm thom khwm tuaj yeem tiv thaiv kev o ntawm ob txhais ceg thiab taw uas feem ntau yog qhov tshwm sim ntawm DVT. Lawv kuj tseem tuaj yeem txo qhov ua rau muaj ntshav txhaws yav tom ntej los ntawm kev nce siab hauv koj ob txhais ceg.

  • Txhawm rau siv cov thom khwm zaws, yooj yim plam lawv hla koj txhais taw thiab nce koj txhais ceg ib yam li koj yuav nrog lub hauv caug-thom khwm lossis thom khwm.
  • Cov thom khwm zaws feem ntau hnav thaum nruab hnub rau ob lossis peb xyoos. Yog tias koj qhov DVT tseem nyob, koj yuav xav hnav thom khwm thom khwm kom ntev dua.
Kho DVT Kauj Ruam 8
Kho DVT Kauj Ruam 8

Kauj Ruam 3. Txais kev hloov lub neej

Tau txais kev tawm dag zog tas li. Lub hom phiaj rau 30-60 feeb ntawm kev tawm dag zog cardio txhua hnub. Kev caij tsheb kauj vab, taug kev, thiab khiav yog txhua yam piv txwv ntawm kev tawm dag zog lub plawv uas tuaj yeem pab koj kho lossis txo qis qhov yuav ua rau koj qhov DVT tsis zoo. Sim siv tus ntaiv hloov lub elevator. Ntxiv rau:

  • Tau nce ntau zaus yog tias koj muaj lub rooj ua haujlwm. Ceev taug kev ncig chaw ua haujlwm txhawm rau tiv thaiv kom tsis txhob txhaws los ntawm koj ob txhais ceg.
  • Mus ntsib kws kho mob tsis tu ncua. Koj tus kws kho mob yuav tuaj yeem muab cov lus qhia tshwj xeeb raws li koj keeb kwm kev kho mob tshwj xeeb thiab keeb kwm yav dhau los uas tuaj yeem pab koj tiv thaiv thiab rov zoo los ntawm DVT.
  • Pw nrog koj ob txhais ceg tsa me ntsis. Yog tias koj tsaug zog nrog koj txhais taw nce txawm tias ob peb ntiv tes siab dua theem ntawm koj lub duav thaum pw, koj cov ntshav yuav rov qab tau yooj yim dua los ntawm txhais ceg thiab rov qab rau koj lub cev. Txhawb koj ob txhais ceg los ntawm kev tso hauv ncoo hauv qab koj txhais taw.

Lub tswv yim

  • Ib txwm siv tshuaj raws li tau hais tseg.
  • Noj koj cov tshuaj tib lub sijhawm txhua hmo. Qhov no yuav tso cai rau koj lub cev nqus cov tshuaj ntawm tus nqi ib txwm dhau sijhawm. Ntxiv rau, thaum koj tau siv sijhawm raws sijhawm, koj yuav tsis tshua muaj qhov tsis nco ntau npaum li cas.

Pom zoo: